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Inflammatory pseudotumors of the liver are rare entities, only few cases being reported so far, pathogenesis of these lesions being scarcely understood. However since now multiple mechanisms have been proposed in order to explain the development of these lesions, the knowledge of their pathogenesis being mandatory in order to further orientate the therapeutic strategy. The current paper is a literature review of the largest studies which aimed to discuss the etiopathogenesis of the inflammatory pseudotumors of the liver.

Introduction Cardiac non-specific inflammatory pseudotumors (NSIPT) are exceptionally associated to Behçet's disease (BD) and represent a real diagnostic and therapeutic challenge. The meaning and the mechanisms of this association are not yet well understood. The purpose of this paper is to study the epidemiologic, therapeutic, and evolutionary characteristics of cardiac NSIPT during BD Methods Systemic review of all reported cases of cardiac NSIPT associated with BD. Results We found only 6 cases of NSIPT associated with BD. Of these six patients, 4 were men (66.66%) and 2 were women (33.33%): Sex ratio =2. The average age was 26.66 years (9-35 years). The pseudotumor was unique in all cases. The chronology of occurrence of these NSIPT compared to the underlying angiitis was variable: inaugural of the disease in 4 cases, and complicating a previously known BD in 2 cases. The surgery was performed in all cases. It was carried out for diagnostic purpose in 4 cases, and therapeutic in the other 2. Additional medical treatment based on systemic corticosteroids with or without immunosuppressants was indicated in 4 patients. The evolution was favorable in 5 cases and a single case was quickly fatal. Recurrence of NSIPT was reported in one patient (20%). Conclusion The results of this review suggest a very likely association between BD and cardiac NSIPT; especially because of the scarcity of these two conditions in the general population, and the epidemiological characteristics clearly different from those of cardiac NSIPTs in the general population. The pathogenic mechanisms common to these two conditions (immune, inflammatory, reactive, and vascular) reinforce this causal link. The main differential diagnoses of these pseudotumors during BD remain cancer and intracardiac thrombosis.

Soft tissue sarcomas encompass multiple entities with differing recurrence rates and follow-up intervals. The detection of recurrences and their differentiation from post-therapeutic changes is therefore complex, with a central role for the clinical radiologist. This article describes approved recommendations. Prerequisite is a precise knowledge of the current clinical management and surgical techniques. We review recurrence rates and treatment modalities. An adequate imaging technique is paramount, and comparison with previous imaging is highly recommended. We describe time-dependent therapy-related complications on magnetic resonance imaging compared with the spectrum of regular post-therapeutic changes. Early complications such as seromas, hematomas, and infections, late complications such as edema and fibrosis, and inflammatory pseudotumors are elucidated. The appearance of recurrences and radiation-associated sarcomas is contrasted with these changes. This systematic approach in follow-up imaging of soft tissue sarcoma patients will facilitate the differentiation of post-therapeutic changes from recurrences.

Inflammatory pseudotumors (IPTs) are rare benign conditions of unknown etiology that can affect any part of the body. IPTs are most commonly associated with Immunoglobulin G4 (IgG4)-related disease. Central nervous system IPTs, especially with pituitary involvement, are even rarer entities. The presence of an IgG4-negative pituitary IPT with simultaneous extracranial involvement has not been reported.We present the case of a 41-year-old female with past medical history of rheumatoid arthritis and a diagnosis of pituitary IPT with coexisting sphenoidal (extracranial) involvement mimicking a pituitary macroadenoma at presentation. The patient underwent multiple consecutive biopsies, and an extensive workup prior to establishing the diagnosis. Laboratory work-up showed normal serum IgG4 and unremarkable liver function tests.Pituitary lesions with simultaneous sphenoidal involvement in patients with IgG4-negative systemic inflammatory disease should raise the clinical suspicion for intracranial IPTs, as these tumors can mimic aggressive counterparts causing adjacent bony erosion, and local invasion.

Aim: Our goal was to determine the histological profile of ENT lesions. Method: We carried out a retrospective and descriptive study in the ENT department and Cervico-Facial Surgery at the university hospital center Gabriel Toure (MALI) from 1995 to 2014. It made it possible to collect 450 cases. Result: We found a male predominance; 51.11% or a sex ratio of 1.04. The mean age of patients was 38.04 years with a standard deviation of 19.49 years and extremes of 3 months and 91 years. Benign tumors were the most frequent (154 cases or 34.22%) including 75 cases of adenomas and 43 cases of papillomas. Cancers accounted for 48.11% (or 153 cases) of all tumors and 34% of lesions. Carcinomas accounted for 81.04%, malignant lymphomas 13.72% and sarcomas 5.22% of cases. Among the 140 cases (31.11%) of inflammatory pseudotumors, we found 12 cases of tuberculosis and 15 cases of rhinoscleroma. Three (3) cases of dysplasia were observed. Conclusion: Interest should be focused on histology in order to initiate appropriate therapy.

Inflammatory pseudotumors are a group of lesions of unknown etiology that mimic clinically and radiographically neoplasms. In the maxilla, inflammatory pseudotumors are presented with bone alterations of erosion, remodeling, and sclerosis. The diagnosis is of exclusion, where multiple biopsies are required. The present study aims to report the case of a male patient who presented with increased volume in the left maxillary region, with diagnosis after total left maxillectomy being inflammatory pseudotumor. The patient did not present recurrences with 3 years of preservation and underwent by multidisciplinary treatment with esthetic and functional rehabilitation with the preparation of a bucomaxilo prosthesis. Despite presenting some suggestive clinical features, the inflammatory pseudotumor has a difficult and of exclusion diagnosis, where multiple biopsies are required. They are lesions that simulate clinically and radiographically neoplasms. If it is surgically accessible, the treatment of choice is complete surgical resection.

Zusammenfassung Hintergrund Tumoren im Bereich der ableitenden Tränenwege (TNW) sind selten. Inflammatorische Pseudotumoren stellen keine Neoplasien im eigentlichen Sinne dar. Aufgrund einer chronischen Entzündung kann es zur Ausbildung von angiomatösen Granulationsgeweben kommen. Patienten Die 1. Kasuistik handelt von einem 53-jährigen Patienten, der nach abgelaufener akuter Dakryozystitis eine persistierende Raumforderung im Bereich der mediokaudalen Orbita aufwies. Mittels diagnostischer Dakryoendoskopie wurde ein großer Dakryolith detektiert. In der anschließend durchgeführten transkutanen Dakryozystorhinostomie (DZR) konnte dieser sowie polypöses Gewebe der Tränensackschleimhaut entfernt werden. Die 2. Kasuistik beschreibt eine 29-jährige Patientin, die 7 Jahre zuvor eine transkanalikuläre TNW-Chirurgie mit Intubation von Silikonstützmaterial erhalten hatte. Anamnestisch bestanden chronisch-rezidivierende mukopurulente Sekretionen sowie eine ausgeprägte Druckschmerzhaftigkeit des Tränensacks. Eine diagnostische Dakryoendoskopie erbrachte den Nachweis von intrasakkal verbliebenem Silikonmaterial. Über eine DZR wurde der Fremdkörper entfernt. Es zeigte sich ferner eine die gesamten ableitenden Tränenwege ausfüllende, polypöse Raumforderung. Ergebnisse Bei beiden Patienten erfolgte eine komplikationslose DZR. Im Rahmen der OP gelang es, den Ductus nasolacrimalis zu rekonstruieren. Die TNW wurden durch den Einsatz von monokanalikulonasalen Intubationen (Kasuistik 1 und 2) sowie einer zusätzlichen Intubation in die Osteotomie (Kasuistik 2) vorübergehend geschient. Histologisch stellte sich bei beiden Patienten ein reaktiver Granulationsgewebspolyp dar. Im postoperativen Verlauf von 9 (Patient 1) bzw. 12 (Patient 2) Monaten waren beide Patienten vollkommen beschwerdefrei, die TNW-Stützmaterialien konnten komplikationslos und vollständig entfernt werden. Schlussfolgerungen Dakryolithen und intrasakkal verbliebene iatrogene Fremdkörper verursachen eine chronische Dakryozystitis. Im Rahmen der Entzündungsreaktion kann es zu einer reaktiven Gewebsneubildung kommen. Es handelt sich hierbei um hypertrophe granulierende Entzündungen. Endogene (Dakryolithen) und exogene (iatrogene Fremdkörper) Noxen sind mögliche zugrunde liegende Auslöser. Die histologische Diagnostik zum Ausschluss anderer entzündlicher Ursachen sowie von Neoplasien ist essenziell.

Inflammatory myofibroblastic tumors (IMT) were previously included in the âinflammatory pseudotumorsâ family, but have emerged as a distinct entity recently. The management of IMT may be challenging due to its intermediate malignant potential. We present a case of a young patient with an asymptomatic retroperitoneal mass with some imaging findings that could point to the IMT diagnosis pre-operatively. After two failed attempts to fully characterize the lesion by percutaneous and surgical biopsy, surgical resection was conducted and the final diagnosis was achieved. Keywords: Inflammatory myofibroblastic tumor, MIBG, Hypervascular mass, Retroperitoneal mass

Inflammatory pseudotumor is a relatively rare, nonneoplastic lesion composed of inflammatory cells and myofibroblastic spindle cells that can be identified on sonographic evaluation of the genitourinary system. These lesions are thought to be an inflammatory response to insults such as surgery, trauma, infection, or malignancy. Such lesions need to be distinguished from true neoplasms and other benign lesions, including inflammatory responses and infectious processes. Identification of inflammatory pseudotumors and its mimics is important for radiologists to guide patient treatment and follow-up. This pictorial essay presents sonographic features of inflammatory pseudotumors of the genitourinary tract and its mimics with cross-sectional imaging and histopathology, where available.

Objectives: This study evaluated whether quantitative perfusion analysis with contrast-enhanced harmonic (CH) endoscopic ultrasonography (EUS) characterizes pancreatic tumors, and compared the hemodynamic parameters used to diagnose pancreatic carcinoma. Methods: CH-EUS data from pancreatic tumors of 76 patients were retrospectively analyzed. Time-intensity curves (TIC) were generated to depict changes in signal intensity over time, and 6 parameters were assessed: baseline intensity, peak intensity, time to peak, intensity gain, intensity at 60 s (I60), and reduction rate. These parameters were compared between pancreatic carcinomas (n = 41), inflammatory pseudotumors (n = 14), pancreatic neuroendocrine tumors (n = 14), and other tumors (n = 7). All 6 TIC parameters and subjective analysis for diagnosing pancreatic carcinoma were compared. Results: Values of peak intensity and I60 were significantly lower and time to peak was significantly longer in the groups with pancreatic carcinomas than in the other 3 tumor groups (p < 0.05). Reduction rate was significantly higher in pancreatic carcinomas than in pancreatic neuroendocrine tumors (p < 0.05). Areas under the receiver-operating characteristic curves for the diagnosis of pancreatic carcinoma using subjective analysis, baseline intensity, peak intensity, intensity gain, I60, time to peak, and reduction rate, were 0.817, 0.664, 0.810, 0.751, 0.845, 0.777, and 0.725, respectively. I60 was the most accurate parameter for differentiating pancreatic carcinomas from the other groups, giving values of sensitivity/specificity of 92.7/68.6% when optimal cutoffs were chosen. Conclusions: In pancreatic carcinomas, TIC patterns were markedly different from the other tumor types, with I60 being the most accurate diagnostic parameter. Quantitative perfusion analysis is useful for differentiating pancreatic carcinomas from other pancreatic tumors.

Tumour-like lesions of the spleen are very rare lesions but can cause diagnostic confusion due to their varying morphologic patterns. These lesions behave in a benign fashion. Included in this group are hamartomas, sclerosing angiomatoid nodular transformation (SANT), inflammatory pseudotumors, and possibly IgG4-related disease. Clinically, these lesions are often discovered incidentally on imaging or at autopsy. However radiological and morphological findings can be misleadingly worrisome. It is therefore important to be familiar with these lesions to distinguish them from malignant lesions.

A hepatic inflammatory pseudotumor, which can be misdiagnosed as a malignant tumor, is a relatively uncommon tumor with nonspecific imaging manifestations. As a new diagnostic technique, contrast-enhanced sonography has become increasingly important in the diagnosis of liver focal lesions. Here we present 3 cases of histologically confirmed hepatic inflammatory pseudotumors diagnosed with contrast-enhanced sonography. "Fast-in and centrifugal-out" may be a characteristic contrast-enhanced sonographic enhancement pattern in the diagnosis of hepatic inflammatory pseudotumors, which needs confirmation in further studies.

We report on four female adolescents, who presented with inflammatory symptoms. Extensive diagnostic workup revealed tumors on different locations. After surgical removal, clinical and laboratory signs of inflammation disappeared rapidly. On histology, the tumors showed a mixture of inflammatory cells characteristic of inflammatory pseudotumors in three of the patients.In patients with unclear inflammatory symptoms, inflammatory pseudotumor should be added to the differential diagnosis.• The inflammatory pseudotumor (IPT) is a mostly benign myofibroblastic tumor of the soft tissue and causes inflammatory symptoms. What is new: • IPTs have may wider than hitherto defined histologic features. Removal of IPT is curative.

Inflammatory pseudotumor is a soft-tissue lesion of unknown etiology, but likely of reactive nature. It is considered benign and treated by simple excision; however, pre-operative diagnosis is often challenging because of the ability of pseudoinflammatory pseudotumor to mimic numerous benign and malignant entities, both clinically and ultrasonographically. Herein, we present the case of a 56-year-old man with a paratesticular inflammatory pseudotumor with concerning clinical features which could not be identified clinically or intra-operatively and thus required an orchiectomy to reach the final diagnosis. In the paratesticular region, inflammatory pseudotumors are uncommon (6% of masses) but must be kept in mind due to their benign nature.

The group of inflammatory pseudotumors (IPTs) encompasses a variety of rare neoplastic and nonneoplastic entities described to occur in almost every location in the body and whose clinical features and aggressive imaging findings (varying from infiltrative to mass-forming lesions), frequently mimic those of malignant tumors. The radiologic features of IPTs are variable and nonspecific, the imaging findings depending on the body location and involved organ. Abdominopelvic IPTs are rare and the purposes of this review, therefore, are to familiarize the radiologist with the wide spectrum of computed tomography and magnetic resonance imaging findings of IPTs in various locations throughout the abdomen and pelvis, discussing the imaging features that allow consideration of IPTs in the differential diagnosis of soft-tissue masses within the pertinent clinical setting. Radiologists should be aware of this group of entities, as a preoperative histopathologic diagnosis upon radiological suspicion may help to differentiate IPTs from malignancy and to allow the most appropriate clinical work-up for these patients.

IgG4-related inflammatory pseudotumors are lesions characterized by plasma cell-rich histologic pattern, abundant IgG4-positive plasma cells and high serum IgG4 levels. A 64-year-old man was admitted to our hospital for an ultrasound-documented space-occupying lesion of the left kidney. Renal tumor of the left kidney was suspected based upon results of computed tomography and nuclear magnetic resonance, and laparoscopic radical nephrectomy was conducted. The final diagnosis of IgG4-related inflammatory pseudotumor was made based on histopathological examination and IgG4 immunostaining. The patient received steroid therapy. To our knowledge, this is the first case of IgG4-related inflammatory pseudotumor of the kidney reported in China.

This study aims to provide an overview of the literature on mesenteric/omental inflammatory pseudotumors (IPTs). We present a new case of mesenteric IPT. We also conducted a systematic search of the English-language medical literature using PubMed, Medline, Google, and Google Scholar related to mesenteric or omental IPTs. The following search terms were used in various combinations: inflammatory myofibroblastic tumor, IPT, mesentery, and omentum. The search included articles published in the English language between January, 1978 and April, 2014. Studies were excluded if the full text was unavailable or missing information prohibited comparisons. A total of 30 reports concerning 36 patients with inflammatory pseudotumors meeting the aforementioned criteria were included. The patients were aged from 10 months to 68 years (mean, 19.98 ± 20.5 years); 12 were female (16.75 ± 16.97 years; range, 10 months to 68 years) and 24 were male (21.6 ± 21.9 years; range, 18 months to 63 years). Detailed clinical and pathologic characteristics of 36 patients with IPTs are provided in Table 1. IPTs may be definitively diagnosed only by histopathological examination and are most effectively treated by resection with negative surgical borders. No consensus has yet been reached regarding when nonsurgical treatment options are most appropriate in management of these lesions. IPTs often recur locally, while distant metastases are very rare. Postoperative close surveillance is essential to detect recurrences early.

OBJECTIVES The purpose of this study was to investigate whether focal fatty sparing can arise in preexisting nonalcoholic diffuse homogeneous fatty liver and its clinical implications. METHODS This prospective study consisted of 2 parts. In the first part, 8598 people (5202 men and 3396 women; mean age ± SD, 43.4 ± 28.3 years; range, 18-82 years) were consecutively evaluated with sonography for abnormal liver findings; in the second part, participants with diffuse homogeneous fatty liver were followed over approximately 3 years. Sonographic findings of the participants in the first year and findings of the participants with diffuse homogeneous fatty liver in the first and third years were analyzed. RESULTS In the first part, 778 of 8598 participants (9.05%) were found to have fatty liver, including 752 cases of nonalcoholic diffuse fatty liver (8.75%) and 26 cases of alcoholic fatty liver (0.30%). Of the 752 cases of nonalcoholic diffuse fatty liver, 301 participants had nonalcoholic diffuse homogeneous fatty liver, and 68 (9.04%) had focal fatty sparing. In the second part, the 301 participants with nonalcoholic diffuse homogeneous fatty liver (205 men and 96 women; mean age, 39.6 ± 10.4 years; range, 18-60 years) were followed. In the third year, 2 cases of fatty liver (0.67%) had resolved, 2 cases (0.67%) had inflammatory pseudotumors, and no focal fatty sparing was found (P < .001). CONCLUSIONS The findings of this study suggest that focal fatty sparing usually does not arise in preexisting nonalcoholic diffuse homogeneous fatty liver, and a newly emerging abnormality is more likely a true lesion.

INTRODUCTIONBiliary inflammatory pseudotumors (IPTs) represent an exceptional benign cause of obstructive jaundice. These lesions are often mistaken for cholangiocarcinomas and are treated with major resections, because their final diagnosis can be achieved only after formal pathological examination of the resected specimen. Consequently, biliary IPTs are usually managed with unnecessary major resections.PRESENTATION OF CASEA 71-year-old female patient underwent an extra-hepatic bile duct resection en-bloc with the gallbladder and regional lymph nodes for an obstructing intraluminal growing tumor of the mid common bile duct (CBD). Limited resection was decided intraoperatively because of negative for malignancy fast frozen sections analysis in addition to the benign macroscopic features of the lesion. Histologically the tumor proved an IPT, arising from the bile duct epithelium, composed of inflammatory cells and reactive mesenchymal tissues.DISCUSSIONThe present case underlines the value of intraoperative reassessment of patients undergoing surgical resection for histopathologically undiagnosed biliary occupying lesions, in order to optimize their surgical management.CONCLUSIONThe probability of benign lesions mimicking cholangiocarcinoma should always be considered to avoid unnecessary major surgical resections, especially in fragile and/or elderly patients.

Purpose To evaluate the role of magnetic resonance (MR) diffusion-weighted imaging (DWI) in discriminating lacrimal masses, including neoplastic and nonneoplastic entities. Materials and Methods Forty-four patients with lacrimal masses underwent conventional MRI and DWI. The apparent diffusion coefficient (ADC) values of each mass and the ipsilateral temporal lobe were measured and the ratios of the lesion to temporal lobe ADC were calculated. Results Pleomorphic adenomas had significantly higher ADC values (1.37 ± 0.22 × 10−3 mm2/sec) and ADC ratios (1.85 ± 0.34) than malignant tumors (1.03 ± 0.19 × 10−3 mm2/sec, 1.37 ± 0.27) (P < 0.001), inflammatory pseudotumors (0.9 ± 0.08 × 10−3 mm2/sec, 1.19 ± 0.07) (P < 0.01), reactive lymphoid hyperplasias (RLHs) (0.6 ± 0.06 × 10−3 mm2/sec, 0.79 ± 0.07) (P < 0.001), and lymphomas (0.55 ± 0.06 × 10−3 mm2/sec, 0.74 ± 0.08) (P < 0.001). RLHs and lymphomas had significantly lower ADC values and ADC ratios than malignant tumors (P < 0.05) and inflammatory pseudotumors (P < 0.05). An ADC value of less than 1.14 × 10−3 mm2/sec and an ADC ratio of less than 1.6 were optimal for differentiating malignant tumors from benign tumors (sensitivity: 80 and 90%, specificity: 100 and 88.9%, respectively). An ADC value of less than 0.76 × 10−3 mm2/sec and an ADC ratio of less than 1.0 were optimal for distinguishing lymphoproliferative disorders from inflammatory pseudotumors (sensitivity: 100%, specificity: 100% for both). Conclusion DWI can help differentiate lacrimal masses and provides a potential clinical tool for noninvasive tissue characterization. J. Magn. Reson. Imaging 2014;40:641–648. © 2013 Wiley Periodicals, Inc.

Inflammatory pseudotumor is the most common primary lung mass in children. In many cases, it mimics organizing pneumonia on imaging tests. Another site often affected by inflammatory pseudotumors is the orbit, although they can be found in any part of the body. Inflammatory pseudotumors are rare and quasi-neoplastic, as radiologically and clinically they behave like malignant tumors. Consensus about their pathogenesis, natural history, imaging findings, and treatment options has yet to be reached.

Inflammatory pseudotumor (IPT) of the liver is a benign condition with a good prognosis. However, it is difficult to distinguish clinical and radiological findings of IPT from those of malignancies. The aims of this study are to determine the clinical, radiological, and pathological characteristics, particularly relating to the role of the autoimmune mechanism in the development of inflammatory pseudotumours (IPTs) of the liver, and to suggest appropriate diagnostic and therapeutic strategy.The clinical, diagnostic, and pathological characteristics including IgG4 immunohistochemical stain and follow-up data of 22 IPT patients were retrospectively analyzed.The patients were 16 men and 6 women with a mean age of 59 years. Fifteen patients (68.2%) had associated biliary diseases. Of the 16 patients treated conservatively, the masses completely resolved in 10 patients, and reduced in size in 5 patients within the first 6 months. The remaining 6 patients were treated by surgical resection. IgG4 staining of 17 tissue samples from 22 patients were negative, most of the infiltrate being of fibrohistiocytic type, whereas 4 of 5 lymphoplasmacytic cells of dominant tumors show positive staining of IgG4. Although IgG4-related sclerosing cholangitis was mostly of lymphoplasmacytic type, other histological and clinical characteristics were similar in both types of IPTs.IPTs of the liver can be diagnosed based on radiological and pathological findings by needle biopsy. Although the lymphoplasmacytic type of IPTs seems to correspond to IgG4-related disease, as assessed by IgG4 immunohistochemical stain, its clinical significance is unknown. Although most IPTs can be resolved with conservative therapy, surgical resection should be considered in cases of uncertain biopsy result, presumed malignant lesion, combination with other pathology, or lack of response to conservative management.

This publication details the indications and contraindications of orbital tumor biopsies and surgical removal. Until now biopsies of pleomorphic adenomas were contraindicated. This management is now being reconsidered. Contrary to past convention, for suspected malignant tumors, a biopsy is essential. Great caution is required in surgery of inflammatory pseudotumors. Surgery is not recommended in lymphomas.

Nasopharyngeal inflammatory pseudotumors are very rare idiopathic infiltrative nasopharyngeal/skull base mass lesions. Imaging findings mimic the local infiltrative and destructive features of nasopharyngeal carcinoma, lymphoma and minor salivary gland tumors however without nodal dissemination. Apparent Diffusion Coefficient determination may aid the discrimination of benign from malignant nasopharyngeal lesions. Confident nasopharyngeal biopsy is required for effective therapeutic management. Failure to recognize this rare inflammatory process contributes to protracted symptomatology including evolving cranial neuropathy.

Inflammatory pseudotumors are rare benign lesions that can occur throughout the body. These masses are usually associated with fever, pain, and mass effect, and are frequently mistaken for malignant neoplasms. Liver pseudotumors are especially rare, with 150 cases reported up to 2007, since the original report of Pack and Baker in 1953. We describe the case of a patient with suspected multiple hepatic abscesses, who was finally diagnosed with an inflammatory pseudotumor by percutaneous biopsy. The patient received prolonged antibiotic therapy, with complete resolution of the pseudotumor. The differential diagnosis and management of this entity is discussed.

Inflammatory pseudotumor is a non-neoplastic inflammatory process. Histologically these lesions appear as an inflammatory infiltrate with a fibrotic background. Clinical presentations vary from slow growth with minimal mass effect, to bony destruction that can mimic malignancy. Although they occur most commonly in the orbit, there are a growing number of case reports of tumors of the temporal bone and skull base. Inflammatory pseudotumors of the temporal bone are best treated by excision, with radiation and steroid therapy reserved for inoperable tumors. The clinical, histologic, and radiographic features of two patients with inflammatory pseudotumor of the temporal bone are presented.

Introduction. Inflammatory pseudotumor is an uncommon entity, and its cardiac origin is exceedingly rare. Case History. A previously healthy 27-year-old man was found to have a systolic murmur during preemployment screening evaluation. A transthoracic echocardiogram revealed a 4 × 2.5 cm mass originating from the right ventricle (RV) outflow tract extending into the aortic root. A computed tomography guided biopsy confirmed an IgG4-related inflammatory pseudotumor. Patient was started on oral prednisone with subsequent reduction in mass size. Conclusion. Cardiac inflammatory pseudotumors are markedly rare tumors that should be considered in the differential of intracardiac tumors which otherwise includes cardiac fibromas, myxomas, and sarcomas.

The generic term urethral benign tumor includes a heterogeneous group of lesions that have diverse characteristics and evolution. Depending on the histological type, they can be classified into: epithelial or mixed tumors (inverted papillomas, fibroepithelial polyps, papillomas), mesenchymal tumors (hemangiomas, rhabdomiomas, leiomyomas, fibromas), and inflammatory pseudotumors (false polyps). They can be located both in the anterior and posterior segments of the urethra.

Inflammatory pseudotumors (IPT) are rare tumors that occur in various organs and tissues. The clinical picture varies from the more frequent benign lesions to rare malignant tumors with distant metastases. IPTs associated with hematopoietic stem cell transplantation (HSCT) is rarely reported. In this article, we review the reports of IPT after HSCT. We also review the possible factors involved in the pathogenesis. IPT may be rare but they are a potentially serious complication of HSCT. A knowledge of these entities and insistence on a definitive biopsy of mass lesions in the post-HSCT period can avoid unnecessary treatment such as radical surgery, chemotherapy or radiotherapy.

To describe the presentation, treatment, and outcome of inflammatory pseudotumors (IPs) of the skull base.English-language articles in PubMed, Web of Science, and EMBASE from earliest available through April 2014.Articles were identified using a keyword search for "inflammatory pseudotumor," "inflammatory myofibroblastoma," or "plasma cell granuloma," including a keyword localizing to the skull base.One hundred papers with 157 cases met inclusion criteria. History, tumor site, initial and subsequent treatment, outcomes, and complications were extracted. Student t test, z test, and analysis of variance were used to analyze demographics, symptoms, sites involved, and outcomes. Odds ratios for site versus initial treatment were calculated.At diagnosis, average patient age was 41 years. Approximately 70% of lesions primarily involved the anterior skull base, 29% the lateral skull base, and 1.2% the occiput. The most common initial treatments were steroids (44%), surgery (28%), and surgery with steroids (16%). Anterior lesions were 55.8 times more likely than lateral lesions to be treated initially with steroids (CI, 14.7-212). Seventy-six percent of patients had stable or resolved symptoms after a single course of treatment.Diagnosis of skull base IP requires ruling out other aggressive pathologies, such as malignancy and infection, and maintaining a high index of suspicion. Surgery is favored for lesions that can be removed in toto with minimal morbidity, as well as steroids for those sites where anatomy limits complete resection, such as within the orbit, cavernous sinus, or brain. An option for larger lesions involving vital anatomy is debulking, followed by postoperative steroids.

Two uncommon cases of locally invasive pulmonary inflammatory myofibroblastic tumor are reported. Diagnosis was established by a prior thoracotomy and incisional biopsy. Complete excision was curative and both children remain asymptomatic at last follow up.

Inflammatory pseudotumors are very rare with hardly over hundred cases reported in literature. The disease is rare in children. The tumor is usually solitary, rarely multifocal. We report on two women old 48 and 49 years. One had a solitary tumor, and the other had four multifocal inflammatory pseudotumors which were surgically removed. Preoperatively both patients had pain, loss in weight, the one had attacks of low grade temperature and the other nausea and general malaise. One patient had leucocytosis. After surgery both patients stayed symptom free with normal laboratory and ultrasonographic findings 6 and 50 months respectively.